CCM 2026 PRACTICE QUESTIONS FOR TEST WITH ALL
CORRECT & 100% VERIFIED ANSWERS|ACTUAL
COMPLETE EXAM|ALREADY GRADED A+
Diagnostic related groups were developed to: ✔Correct Answer-Pay hospital rate.
To coordinate cost effective quality homecare products and services the case manager should:
✔Correct Answer-Critically assess providers
A type of health care insurance that covers out of pocket cost for Medicare covered services is:
✔Correct Answer-Medigap
Which of the following statements best defines return on investment ROÍ? ✔Correct Answer-The
ratio of care cost to savings.
Extra contractual benefits are: ✔Correct Answer-Sometimes an option when alternative sources
are unavailable.
In reference to mental health,the term co occurring disorder is used interchangeably with :
✔Correct Answer-Dual diagnosis
A healthcare cost trend factor that can be most directly impacted by case manager s is: ✔Correct
Answer-Intensity of service
Disease management programs typically focus on patients with: ✔Correct Answer-Chronic
illnesses
cost benefit analysis reports include: ✔Correct Answer-Alternative treatment plans.
Case managers must intervene if which of the following are identified? ✔Correct Answer-Safety
concerns
Legally, a client has which of the following rights in regard to personal health information?
✔Correct Answer-Read information in the file
Discharge planning a spinal cord injury should begin: ✔Correct Answer-At time of admission
The use of telemedicine by home agencies ✔Correct Answer-Can provide improved patient access.
An example of a reasonable accommodation is: ✔Correct Answer-Providing a medical examination
for the individual with a disability so that the employer will know what environmental changes are
needed.
Utilization review and accreditation committee URAC accreditation is: ✔Correct Answer-National
recognized and reputable
Motivational interviewing theory,a individual in the contemplation stage of change: ✔Correct
Answer-acknowledges there is a problem
, The contractual right to recover payment made to claimant for healthcare costs after that claimant
has received payment for damages in a legal action is: ✔Correct Answer-Subrogation
case management organizations are frequently challenged to manage caseloads for effective,quality
practice. Which of the following is a major consideration? ✔Correct Answer-The case management
model
The most common barrier to obtaining access to resources and services for the chronically ill elderly
persons is: ✔Correct Answer-Financial limitations
A diabetic action plan is an effective tool in helping a client make behavior changes by: ✔Correct
Answer-Defining self management goals.
Higher order norms or fundamental assumptions that are consistent with a society's moral principles
and constitute higher standards of moral behavior are: ✔Correct Answer-Ethical principles
The state children's Health Insurance Program SCHIP provides health insurance coverage for
uninsured and underinsured children who: ✔Correct Answer-Have household income above the
Medicaid qualifying income.
The need for nursing home care for the elderly has declined due to : ✔Correct Answer-
Development of alternative community caregiving arrangements
The goal of work hardening include, ✔Correct Answer-Increase confidence,control of
manifestation of condition ,and increased work tolerance and rate.
When a case manager coordinates the transfer of a catastrophically or chronically ill patient from one
facility to another, ✔Correct Answer-The case manager can usually claim a savings if the patient
transfers from higher to a lower intensity of care
The attainment of a level of competence that allows a client to return to work is a goal of:
✔Correct Answer-Work hardening
Historically, senior programs in the US have not served older people well due to: ✔Correct Answer-
Lack of care coordination
Intensity of services and severity of illness are factors considered in which of the following utilization
management guideline sets? ✔Correct Answer-Interqual.
Which of the following organizations provide a systematic review of managed care organizations for
accreditation ✔Correct Answer-NCQA
For patients with dual diagnosis, gap and fragmentation of care can be avoided if the healthcare
team exercises close collaborator and: ✔Correct Answer-Communication
When a case manager's secondary activities have the potential to compromise primary
responsibilities, this is referred as: ✔Correct Answer-Conflict of interest
Two essential components of a risk management program are: ✔Correct Answer-Loss control and
loss prevention
CORRECT & 100% VERIFIED ANSWERS|ACTUAL
COMPLETE EXAM|ALREADY GRADED A+
Diagnostic related groups were developed to: ✔Correct Answer-Pay hospital rate.
To coordinate cost effective quality homecare products and services the case manager should:
✔Correct Answer-Critically assess providers
A type of health care insurance that covers out of pocket cost for Medicare covered services is:
✔Correct Answer-Medigap
Which of the following statements best defines return on investment ROÍ? ✔Correct Answer-The
ratio of care cost to savings.
Extra contractual benefits are: ✔Correct Answer-Sometimes an option when alternative sources
are unavailable.
In reference to mental health,the term co occurring disorder is used interchangeably with :
✔Correct Answer-Dual diagnosis
A healthcare cost trend factor that can be most directly impacted by case manager s is: ✔Correct
Answer-Intensity of service
Disease management programs typically focus on patients with: ✔Correct Answer-Chronic
illnesses
cost benefit analysis reports include: ✔Correct Answer-Alternative treatment plans.
Case managers must intervene if which of the following are identified? ✔Correct Answer-Safety
concerns
Legally, a client has which of the following rights in regard to personal health information?
✔Correct Answer-Read information in the file
Discharge planning a spinal cord injury should begin: ✔Correct Answer-At time of admission
The use of telemedicine by home agencies ✔Correct Answer-Can provide improved patient access.
An example of a reasonable accommodation is: ✔Correct Answer-Providing a medical examination
for the individual with a disability so that the employer will know what environmental changes are
needed.
Utilization review and accreditation committee URAC accreditation is: ✔Correct Answer-National
recognized and reputable
Motivational interviewing theory,a individual in the contemplation stage of change: ✔Correct
Answer-acknowledges there is a problem
, The contractual right to recover payment made to claimant for healthcare costs after that claimant
has received payment for damages in a legal action is: ✔Correct Answer-Subrogation
case management organizations are frequently challenged to manage caseloads for effective,quality
practice. Which of the following is a major consideration? ✔Correct Answer-The case management
model
The most common barrier to obtaining access to resources and services for the chronically ill elderly
persons is: ✔Correct Answer-Financial limitations
A diabetic action plan is an effective tool in helping a client make behavior changes by: ✔Correct
Answer-Defining self management goals.
Higher order norms or fundamental assumptions that are consistent with a society's moral principles
and constitute higher standards of moral behavior are: ✔Correct Answer-Ethical principles
The state children's Health Insurance Program SCHIP provides health insurance coverage for
uninsured and underinsured children who: ✔Correct Answer-Have household income above the
Medicaid qualifying income.
The need for nursing home care for the elderly has declined due to : ✔Correct Answer-
Development of alternative community caregiving arrangements
The goal of work hardening include, ✔Correct Answer-Increase confidence,control of
manifestation of condition ,and increased work tolerance and rate.
When a case manager coordinates the transfer of a catastrophically or chronically ill patient from one
facility to another, ✔Correct Answer-The case manager can usually claim a savings if the patient
transfers from higher to a lower intensity of care
The attainment of a level of competence that allows a client to return to work is a goal of:
✔Correct Answer-Work hardening
Historically, senior programs in the US have not served older people well due to: ✔Correct Answer-
Lack of care coordination
Intensity of services and severity of illness are factors considered in which of the following utilization
management guideline sets? ✔Correct Answer-Interqual.
Which of the following organizations provide a systematic review of managed care organizations for
accreditation ✔Correct Answer-NCQA
For patients with dual diagnosis, gap and fragmentation of care can be avoided if the healthcare
team exercises close collaborator and: ✔Correct Answer-Communication
When a case manager's secondary activities have the potential to compromise primary
responsibilities, this is referred as: ✔Correct Answer-Conflict of interest
Two essential components of a risk management program are: ✔Correct Answer-Loss control and
loss prevention
